Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain; Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; Institute of Neuroscience, Hospital Clinic of Barcelona, Barcelona, Spain.
J Affect Disord. 2021 Mar 1;282:757-765. doi: 10.1016/j.jad.2020.12.090. Epub 2020 Dec 28.
Neurocognitive impairment is considered to lie on a continuum of severity across schizophrenia (SZ) and bipolar disorder (BP), possibly reflecting a gradient of neurodevelopmental load. Cluster analyses have identified different levels of impairment across the two disorders, from none to widespread and severe. We for the first time used this approach to examine cognitive function pooling together children and adolescents at familial risk of SZ or BP.
220 participants, 49 offspring of individuals with schizophrenia (SZO), 90 offspring of individuals with bipolar disorder (BPO) and 81 offspring of healthy control parents (HC), aged 6 to 17 years, underwent a comprehensive clinical and cognitive assessment. Cognitive measures were used to group SZO and BPO using K-means clustering. Cognitive performance within each of the clusters was compared to that of HC and clinical variables were compared between clusters.
We identified three cognitive subgroups: a moderate impairment group, a mild impairment group, and a cognitively intact group. Both SZO and BPO were represented in each of the clusters, yet not evenly, with a larger proportion of the SZO in the moderately impaired cluster, but also a subgroup of BPO showing moderate cognitive dysfunction.
Participants have yet to reach the age of onset for the examined disorders.
The findings point to a range of neurodevelopmental loadings across youth at familial risk of both SZ and BP. They have therefore important implications for the stratification of cognitive functioning and the possibility to tailor interventions to individual levels of impairment.
神经认知障碍被认为存在于精神分裂症（SZ）和双相情感障碍（BP）之间的严重程度连续体上，这可能反映了神经发育负荷的梯度。聚类分析已经确定了两种疾病在不同程度上的损害，从没有到广泛和严重。我们首次使用这种方法来研究认知功能，汇集了有 SZ 或 BP 家族风险的儿童和青少年。
220 名参与者，49 名 SZ 个体的子女（SZO），90 名 BP 个体的子女（BPO）和 81 名健康对照父母的子女（HC），年龄在 6 至 17 岁之间，接受了全面的临床和认知评估。使用 K-均值聚类对 SZO 和 BPO 进行认知分组。将每个聚类中的认知表现与 HC 进行比较，并比较聚类之间的临床变量。
我们确定了三个认知亚组：中度受损组、轻度受损组和认知完整组。每个聚类中都有 SZO 和 BPO，但分布不均，中度受损聚类中 SZO 的比例较大，但也有一部分 BPO 表现出中度认知功能障碍。
参与者尚未达到所研究疾病的发病年龄。
这些发现表明，在有 SZ 和 BP 家族风险的青年中，存在着一系列不同的神经发育负荷。因此，这对认知功能的分层以及根据个体的受损程度来定制干预措施具有重要意义。
